What Mitt Romney Has to Do with Breast-Feeding and Infant Formula

Massachusetts has become the second state in the country whose hospitals ban free formula gifts to new moms — more than six years after then-Gov. Mitt Romney overturned the state's first attempt to institute a ban. What happened?

If ever there were proof that breast-feeding is a political issue, consider what appears to be a most unusual association between presidential candidate Mitt Romney and the right of new moms in Massachusetts not to be influenced by free hospital giveaways of infant formula, which serve to discourage women from breast-feeding.

On Wednesday, a coalition of breast-feeding advocates will gather at the Massachusetts State House to celebrate the state becoming the second in the nation whose hospitals have banned the distribution of formula goodie bags to mothers who’ve just given birth. There will be cake and coffee, speeches from the medical director of the state Department of Public Health (DPH) and other supporters, all taking place beneath a banner that reads: “Why are hospitals marketing baby formula? Give the bag the boot.”

“Among breast-feeding advocates, this has always been a thorn in our side,” says Melissa Bartick, an instructor in medicine at Harvard Medical School and chair of the state’s breast-feeding coalition. “It seems so hopeless to fight against these formula companies, but at the same time, hospitals are marketing baby formula, which undermines breast-feeding and sends a poor message. What’s amazing is that we have been able to stand up to corporate interests in the name of public health.”

Rhode Island, with seven maternity hospitals, set the stage in 2011; Massachusetts has followed in its footsteps, successfully persuading its 49 maternity hospitals that gifting free formula to new moms at a time when the U.S. Surgeon General and the American Academy of Pediatrics have made breast-feeding a public-health priority doesn’t seem very intuitive.

Of course, whether you believe that receiving free formula as a hospital goodbye gift represents a conflict of interest varies widely. Peggy O’Mara, editor-in-chief of Mothering magazine, has criticized the practice:

It is naïve to believe that the formula industry’s distribution of formula to you is an innocent gift. A “gift” of formula is like a “gift” of a pack of cigarettes when you’re trying to quit smoking; it will undermine your resolve. The formula company has bought your name and address from the hospital, without your knowledge, and will now solicit you for sales. Do you really want this commercial intrusion into your life?

But Mitt Romney, who was governor of Massachusetts when DPH first tried to ban the freebies in Dec. 2005, disagreed. His spokesman, Eric Fehrnstrom, told the Boston Globe a few months later, in Feb. 2006, that the decision to accept formula swag bags should be up to each individual mother:

“We’re not disputing the health benefits of breast-feeding, but we think that new mothers should make that choice. If they choose to bottle-feed, they should be supported in that decision.”

With Romney seeking the presidency, breast-feeding supporters in Massachusetts now find themselves rehashing what transpired in early 2006, when the then-Governor reversed DPH’s decision to discontinue the free-formula practice; he replaced three Public Health Council members who expressed displeasure over the ban’s reversal. Then, within days, came an announcement from Bristol-Myers Squibb — whose Mead Johnson Nutrition unit makes Enfamil formula — that it would build a pharmaceutical plant in the state.

Did Gov. Romney put the kibosh on the formula ban in order to woo Bristol-Myers Squibb? Romney’s press team did not respond to requests for comment. But Michelle Nicholasen, a former Frontline producer turned freelance journalist, has spent six months investigating the chronology. “What caused the abrupt change in the administration?” says Nicholasen. “All signs point to Bristol-Myers coming to town.”

Bartick is even more blunt about her assessment of Romney, who ran for the Republican presidential nomination in 2008. “We thought that Mitt Romney sold out the health of mothers and babies in Massachusetts to burnish his presidential resume,” she says.

Frustrated but not about to give up, Bartick and other breast-feeding advocates launched Ban the Bags in July 2006, creating a website and soliciting donations to help hospital employees lobby against the formula-laden diaper bags nationwide. Once Romney left office in 2007, the advocates partnered with Massachusetts’ DPH and actively worked to get hospitals on board.

So far, more than 600 hospitals across the country have signed on, according to Ban the Bags — just a fraction of the nation’s maternity hospitals. A study published last year in Pediatrics found that just a quarter of U.S. maternity hospitals have banned formula bags, though that’s an increase from 2007 when just 14% did. Indeed, “banning the bags” has increasingly become a point of pride, with hospitals issuing press releases when they opt not to gift free formula.

Some of the newfound interest may reflect the health care industry’s “general ethical shift away from giving stuff out,” Anne Merewood, the study’s senior author, told Healthland last year. But researchers have also played a role, finding that new moms who get free formula may be less successful at breast-feeding.

As Merewood noted:

“Someone might go home from the hospital determined to breast-feed, but if there’s formula sitting right there, they are more likely to use it. If it’s being endorsed by hospitals, people think there can’t be anything wrong with it.”